Retraction tube for use with capless pedicle screw

ABSTRACT

A retractor system and method for locating and placing a polyaxial screw while substantially simultaneously retracting tissue is shown and described. The retractor has a channel that facilitates introducing a rod into the polyaxial screw. Various embodiments are shown, including one which utilized a reducer for moving the rod in the retractor.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. application Ser. No.13/355,654 filed Jan. 23, 2012, which is a continuation of U.S.application Ser. No. 12/477,489 filed Jun. 3, 2009, now issued as U.S.Pat. No. 8,142,436, which claims priority to provisional U.S.Application Ser. No. 61/059,417 filed Jun. 6, 2008, to which Applicantclaims the benefit of the earlier filing date. These applications areincorporated herein by reference and made a part hereof

BACKGROUND OF THE INVENTION

1. Field of the Invention

A retraction tube for use with a capless spinal screw which allows forthe rotation of the screw locking body within, and relative to, theretraction tube. In another embodiment, a retraction tube for use with acapless spinal screw which attaches rigidly to said screw and isdimensioned to permit rotation of said tubular attachment relative to afixation element.

2. Description of the Related Art

The placement of spinal screws is a common surgical procedure. There isa need to reduce the size of the incision necessary for the placement ofsuch screws. Small tubular tissue retractors have been used to minimizeincision size. More recently, tubular attachments have been developedwhich attach to the screws themselves, performing tissue retractionduring the act of screw placement. Typically, the screws are engagedinto bone, while the retraction tubes protrude upward through the skin.At this point a fixation element, typically a metallic rod, is placedeither through or adjacent to the retraction tubes in order to engagethe screws. Typically, a locking cap is then placed through the tube tolock the fixation element to the screws. As demonstrated in the priorart, such tubes attach rigidly to the screw body and do not permit therotation of the screw body needed to perform locking of the fixationelement to the screws.

Recently, there has been the development of capless spinal screws whichutilize rotation of the screw body to achieve locking of the fixationelement to the capless screws. Current retraction tubes are not capableof being used with capless screws. Since capless screws require rotationof the screw body in order to perform rod locking, an improvedretraction tube is needed which allows for rotational screw locking totake place within the tube.

SUMMARY OF THE INVENTION

One object of the invention is to provide a retractor for retractingtissue and that is adapted to rotate or permit rotation of a capped orcapless polyaxial screw.

Another object of the invention is to provide a reducer for moving therod in the retractor.

In one aspect, an embodiment comprises a retractor/reducer assembly foruse in combination with a reducer comprising a retractor comprising anelongated member for detachably mounting onto a polyaxial screw receiverhaving a rod-locking channel for receiving and locking onto a rod, theelongated member comprising a rod-receiving channel for receiving therod and for guiding the rod into the rod-locking channel, the elongatedmember having a first end for receiving and detachably mounting onto thepolyaxial screw receiver; and a reducer for rotatably mounting on theelongated member, at least a portion of the reducer extending over andat least partially surrounding the polyaxial screw receiver and having agenerally helical channel for receiving the rod and for urging the rodto move in the rod-receiving channel of the retractor and into therod-locking channel in response to rotation of the reducer. In anotheraspect, another embodiment comprises a retractor comprising a reducercomprising an elongated tubular member having a generally helicalreducer channel, the elongated tubular member being adapted andconfigured to mount onto a polyaxial screw receiver having a rod-lockingchannel, the generally helical reducer channel receiving a rod andcausing the rod to move in the rod-locking channel the polyaxial screwreceiver in response to a rotation of the elongated tubular member, atleast a portion of the reducer extending over and at least partiallysurrounding the polyaxial screw receiver and having a generally helicalchannel for receiving the rod and for urging the rod to move into therod-locking channel in response to rotation of the reducer.

The above mentioned aspects and the embodiments shown and describedherein could be used alone or together and/or in combination with one ormore of the features covered by one or more of the claims set forthherein, including but not limited to one or more of the followingfeatures or steps:

The retractor wherein the elongated member comprises at least one innerwall for mounting onto an outer surface of the polyaxial screw receiver,the at least one inner wall being adapted to permit the polyaxial screwreceiver to be rotated by rotating the elongated member until the rodbecomes locked in the polyaxial screw receiver.

The retractor wherein the elongated member comprises at least one innerwall for mounting onto an outer surface of the polyaxial screw receiver,the at least one inner wall being adapted to permit the polyaxial screwreceiver to be rotated to lock the rod in the polyaxial screw receiverwhile the elongated member is held stationary.

The retractor wherein the elongated member is adapted to permit theelongated member to be removed from the polyaxial screw receiver bymoving the elongated member axially away from the polyaxial screwreceiver after the polyaxial screw receiver has been rotated.

The retractor wherein at least a portion of the rod-receiving channelcomprises a shape or configuration that is generally the same as a shapeor configuration of the rod-locking channel so that when the elongatedmember is mounted onto the polyaxial screw receiver, the rod-receivingchannel and the rod-locking channel can become generally aligned topermit the rod to be received so that the elongated member can berotated in a first direction to cause the polyaxial screw receiver tolock the rod in the polyaxial screw receiver and then rotated in asecond direction generally opposite the first direction withoutunlocking the rod from the polyaxial screw receiver.

The retractor wherein the elongated member comprises an end having afirst recessed wall and a second recessed wall that generally opposesthe first recessed wall, the first and second recessed walls defining afirst shape that generally complements a second shape of an outersurface of the polyaxial screw receiver.

The retractor wherein the first and second shapes are arcuate anddimensioned to enable the end of the elongated member to be fit onto thepolyaxial screw receiver with a press or interference fit.

The retractor wherein a frictional engagement between the first andsecond recessed walls and the outer surface is less than a couplingstrength between the polyaxial screw receiver and the rod, therebypermitting the elongated member to rotate after the polyaxial screwreceiver is locked onto the rod and without unlocking the the polyaxialscrew receiver from the rod.

The retractor wherein the elongated member adapted to permit theelongated member to be removed from the polyaxial screw receiver bymoving the elongated member axially away from the polyaxial screwreceiver after the rod is locked in the polyaxial screw receiver.

The retractor wherein the rod-receiving channel traverses a majority ofa longitudinal length of the elongated member.

The retractor wherein the rod-locking channel is not entirely straightand the rod-receiving channel is generally straight.

The retractor wherein neither of the rod-locking channel nor therod-receiving channel is straight.

The retractor wherein the elongated member comprises a first end havinga recessed area adapted to capture the polyaxial screw receiver with africtional engagement that permits the polyaxial screw receiver to berotated by the elongated member and permit the elongated member torotate or move independent of any movement of the polyaxial screwreceiver.

The retractor wherein the first end comprises a coupler or aligner forfacilitating coupling or aligning, respectively, the elongated member tothe polyaxial screw receiver.

The retractor wherein the coupler comprises at least one projection onat least one of the elongated member or the polyaxial screw receiver anda generally complementary receiving area on the other of the polyaxialscrew receiver or the at least one of the elongated member,respectively, for receiving the at least one projection to facilitatecoupling the elongated member to the polyaxial screw receiver.

The retractor wherein the coupler or aligner causes the rod-lockingchannel and the rod-receiving channel to become generally aligned whenthe elongated member is mounted onto the polyaxial screw receiver.

The retractor wherein the elongated member is generally tubular andcomprises a first arcuate wall and a second arcuate wall generallyopposing the first arcuate wall, the first and second arcuate wallshaving ends that are spaced to define the rod-receiving channel, theelongated member is sized to permit a tool to be used to screw the screwafter it is received in the polyaxial screw receiver and the elongatedmember is mounted onto the polyaxial screw receiver.

The retractor wherein the elongated member comprises a first end formounting onto the polyaxial screw receiver and a second end opposite thefirst end, the second end having a stabilizer for holding the elongatedmember.

The retractor wherein the retractor further comprises a reducer forrotatably mounting on the elongated member, the reducer urging the rodto move in the rod-receiving channel and into the rod-locking channel.

The retractor wherein the reducer comprises a reducer channel.

The retractor wherein the reducer channel is non-linear.

The retractor wherein the reducer channel is helical, the reducerfurther comprising a tubular wall having a first cut out area and asecond cut out area, the first and second cut out areas being spacedapproximately 180 degrees and defining the reducer channel.

The retractor wherein the reducer comprises a grip for manually rotatingthe reducer about the elongated member.

The retractor wherein the reducer comprises an internal reducerreceiving area adapted and dimensioned to receive the elongated memberso that the reducer can be rotatably mounted thereon.

The retractor wherein the elongated member is tubular and the reducer isadapted and dimensioned to be rotatably mounted inside the elongatedmember.

The retractor wherein the rod-receiving channel of the elongated memberand the reducer channel are adapted to receive the rod and cooperate toguide and urge rod into the rod-locking channel upon rotation of thereducer.

The retractor wherein an end of the reducer comprises at least one stopto prevent over rotation of the reducer once the rod is captured in aseat of the rod-locking channel or the polyaxial screw receiver.

The reducer wherein the reducer channel is non-linear.

The reducer wherein the reducer channel is helical, the reducer furthercomprising a tubular wall having a first cut out area and a second cutout area, the first and second cut out areas being spaced approximately180 degrees and defining the helical reducer channel.

The reducer wherein the reducer comprises a grip for manually rotatingthe reducer about the elongated member.

The reducer wherein the reducer comprises an internal reducer receivingarea adapted and dimensioned to receive the elongated member of theretractor so that the reducer can be rotatably mounted on the elongatedmember.

The reducer wherein the elongated member of the retractor and thereducer are both tubular, the reducer being adapted and dimensioned tobe rotatably mounted inside the elongated member.

The reducer wherein the reducer comprises at least one stop associatedwith the reducer channel to prevent over rotation of the reducer oncethe rod is captured in a seat of the rod-locking channel or thepolyaxial screw receiver.

The retractor wherein the retractor body further comprises at least oneinner wall for mounting onto an outer surface of the polyaxial screwreceiver, the at least one inner wall being adapted to cause thepolyaxial screw receiver to rotate by rotating the retractor body untilthe rod becomes locked in the polyaxial screw receiver.

The retractor wherein the retractor body comprises at least one innerwall for mounting onto an outer surface of the polyaxial screw receiver,the at least one inner wall being adapted to permit the polyaxial screwreceiver to be rotated to lock the rod in the polyaxial screw receiverwhile the retractor body is held stationary.

The retractor wherein the retractor body is adapted to permit theretractor body to be removed from the polyaxial screw receiver by movingthe retractor body axially away from the polyaxial screw receiver afterthe polyaxial screw receiver has been rotated.

The retractor wherein at least a portion of the rod-receiving channelcomprises a shape or configuration that is generally the same as a shapeor configuration of the rod-locking channel so that when the retractorbody is mounted onto the polyaxial screw receiver, the rod-receivingchannel and the rod-locking channel become generally aligned to enablethe retractor body to be rotated in a first direction to cause thepolyaxial screw receiver to rotate and lock the rod in the polyaxialscrew receiver and then rotated in a second direction generally oppositethe first direction without rotating the polyaxial screw receiver in thesecond direction.

The retractor wherein the retractor body comprises an end having a firstrecessed wall and a second recessed wall that generally opposes thefirst recessed wall, the first and second recessed walls cooperating todefine a female receiving area that generally complements and mates withan outer surface of the polyaxial screw receiver.

The retractor wherein the end of the retractor body fits onto thepolyaxial screw receiver with a press or interference fit.

The retractor wherein a frictional engagement between the first andsecond recessed walls and the outer surface is less than a couplingstrength between the polyaxial screw receiver and the rod, therebypermitting the retractor body to rotate after the polyaxial screwreceiver is locked onto the rod without unlocking the polyaxial screwreceiver from the rod.

The retractor wherein the retractor body is adapted to permit theretractor body to be removed from the polyaxial screw receiver by movingthe retractor body axially away from the polyaxial screw receiver afterthe rod is locked in the polyaxial screw receiver.

The retractor wherein the rod-receiving channel traverses a majority ofa longitudinal length of the retractor body.

The retractor wherein the rod-locking channel is not entirely straightand the rod-receiving channel is generally straight.

The retractor wherein neither the rod-locking channel nor therod-receiving channel are straight.

The retractor wherein the retractor body comprises a first end having arecessed area adapted to capture the polyaxial screw receiver with africtional engagement that permits the polyaxial screw receiver to berotated by the retractor body and permit the retractor body to rotate ormove independent of any movement of the polyaxial screw receiver.

The retractor wherein the first end comprises a coupler or aligner forfacilitating coupling or aligning the retractor body to the polyaxialscrew receiver.

The retractor wherein the coupler comprises at least one projection onat least one of the retractor body or the polyaxial screw receiver and agenerally complementary receiving area on the other of the polyaxialscrew receiver or the at least one of the retractor body, respectively,for receiving the at least one projection to facilitate coupling theretractor body to the polyaxial screw receiver.

The retractor wherein the coupler causes the rod-locking channel and therod-receiving channel to become generally aligned when the retractorbody is mounted onto the polyaxial screw receiver.

The retractor wherein the retractor body is generally tubular andcomprises a first arcuate wall and a second arcuate wall generallyopposing the first arcuate wall, the first and second arcuate wallshaving ends that are spaced to define the rod-receiving channel, theretractor body is sized to permit a tool to be used to screw the screwafter it is received in the polyaxial screw receiver and the retractorbody is mounted onto the polyaxial screw receiver.

The retractor wherein the retractor body comprises a first end formounting onto the polyaxial screw receiver and a second end opposite thefirst end, the second end having a stabilizer for holding the retractorbody.

The retractor wherein the retractor further comprises a reducer forrotatably mounting on the retractor body, the reducer urging the rod tomove in the rod-receiving channel and into the rod-locking channel.

The retractor wherein the reducer comprises a reducer channel.

The retractor wherein the reducer channel is non-linear.

The retractor wherein the reducer channel is helical, the reducerfurther comprising a tubular wall having a first cut out area and asecond cut out area, the first and second cut out areas being spacedapproximately 180 degrees and defining the helical reducer channel.

The retractor wherein the reducer comprises a grip for manually rotatingthe reducer about the retractor body.

The retractor wherein the reducer comprises an internal reducerreceiving area adapted and dimensioned to receive the retractor body sothat the reducer can be rotatably mounted thereon.

The retractor wherein the retractor body is tubular and the reducer isadapted and dimensioned to be rotatably mounted inside the retractorbody.

The retractor wherein the rod-receiving channel of the retractor bodyand the reducer channel are adapted to receive the rod and cooperate toguide and urge the rod into the rod-locking channel upon rotation of thereducer.

The retractor wherein the reducer comprises at least one stop associatedwith the reducer channel to prevent over rotation of the reducer oncethe rod is captured in a seat of the rod-locking channel or thepolyaxial screw receiver.

These and other objects and advantages of the invention will be apparentfrom the following description, the accompanying drawings and theappended claims.

DETAILED DESCRIPTION OF THE ACCOMPANYING DRAWINGS

FIG. 1 is perspective view of a retraction device or apparatus accordingto one embodiment of the invention;

FIG. 2 is a sectional view of a retraction device or apparatus, takenalong line 2-2 of FIG. 1;

FIG. 3 is a sectional view taken along line 3-3 of FIG. 1;

FIG. 4 is a view of the retraction device or apparatus;

FIG. 5 is a sectional view of the retraction device or apparatus, takenalong line 5-5 of FIG. 4;

FIG. 6 is a fragmentary view, partly in cross-section, of a retractiondevice or apparatus with a capless screw engaged;

FIG. 7 is a fragmentary view of a retraction device or apparatus with acapless screw engaged;

FIG. 8 is a fragmentary view, similar to FIG. 7, showing anotherposition thereof;

FIG. 9 is an exploded view of another embodiment of a retraction deviceor apparatus;

FIG. 10 is a view similar to FIG. 9, showing the retractor mounted on acapless polyaxial screw;

FIG. 11 is a fragmentary view of the retraction device or apparatus andcapless screw rigidly fixed and showing a rod in a first position;

FIG. 12 is a view similar to FIG. 11 with the rod moved to anotherposition;

FIG. 13 is an enlarged fragmentary view showing the retraction device orapparatus and screw with a locking interface so that rotation of thetube in turn causes rotation of the receiver into a locking position;

FIG. 14 is a perspective view of another embodiment showing a retractorand a reducer;

FIGS. 15-17 are various views illustrating the reducer urging or forcingthe rod into a rod-locking channel of the receiver;

FIG. 18 is a view illustrating the reducer being removed from theretractor;

FIG. 19 is a view illustrating the retractor rotating the receiver afterthe rod is received in the rod-locking channel and the reducer has beenremoved from the retractor;

FIG. 20 is a sectional view taken along the lines 20-20 in FIG. 17; and

FIG. 21 is an exploded view showing reducer that fits inside theretractor.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Referring now to FIGS. 1-21, a retraction tube system is showncomprising a retractor, retraction device or apparatus 10. A firstillustrative embodiment is shown relative to FIGS. 1-8 wherein aretractor, retraction device or apparatus 10 is shown. As illustrated inFIG. 1, the retractor, retraction device or apparatus 10 comprises agenerally tubular or cylindrical retractor body 12 having an inner wall12 a that defines an aperture 14. The retractor, retraction device orapparatus 10 in the illustration being shown is tubular and cylindricalin cross section. A pair of cut-outs 16 and 18 is provided in theretractor body 12. The cut-outs 16 and 18 define a first elongatedportion, leg or wall 20 and a second elongated portion, leg or wall 22as shown. The cut-outs 16 and 18 also cooperate to define arod-receiving channel 26 for receiving a rod 28.

Note that an end 20 a (FIG. 1) of the first elongated portion 20 has aninner wall 20 c (FIG. 2) having a recessed wall 20 a 1, and an end 22 aof the second elongated portion 22 has an inner wall 22 c (FIG. 2)having a recessed wall 22 a 1. The recessed walls 20 a 1 and 22 a 2cooperate to define an area 24 for receiving a polyaxial screw 29 (FIGS.8 and 9). In the illustration being described, the polyaxial screw 29comprises a capless receiver or polyaxial screw receiver 30 and a screw29 a (FIG. 8) that is received in the capless receiver 30. The polyaxialscrew 29 may be of the type as shown and illustrated in U.S. Pub. PatentApplication Nos. 200710043357A1, now issued as U.S. Pat. No. 7,717,943;2007/0123867A1; 20060155278A1, now issued as U.S. Pat. No. 7,662,172;2007/0123862A1, now issued as U.S. Pat. No. 7,604,655; 2008/0097457A1,now issued as U.S. Pat. No. 8,012,185; 2008/0071277A1, now issued asU.S. Pat. No. 8,092,504; 2008/0249576A1, now issued as U.S. Pat. No.8,097,025; 2007/0093827A1, now issued as U.S. Pat. No. 7,686,835, all ofwhich are assigned to the same assignee as the present application andwhich are incorporated herein by reference and made a part hereof. Thepolyaxial screw 29 may comprise at least one inner member (not shown),such as a compression member (not shown), of the type disclosed in oneor more of the cited applications.

Note that the receiver 30 comprises a generally L-shaped rod-lockingchannel or slot 30 a (FIGS. 6-8) conventionally known. The rod-lockingchannel 30 a has an opening 30 a 1, a seat 30 a 2, and a seat 30 a 3 asshown in FIG. 6. The receiver 30 comprises an outer surface 30 b thathas a diameter that is dimensioned or adapted to permit the receiver 30to be received in the receiving area 24 and rotate within and relativeto the retraction device or apparatus 10 after the receiver 30 isreceived between the recessed walls 20 a 1 and 22 a 1 in the receivingarea 24. Note that the outer wall 30 b of receiver 30 may comprise a lipor flange 30 b 1 having a retaining function described later herein.

As best illustrated in FIGS. 1 and 7, notice that the retractor body 12has the pair of generally opposed walls, legs, portions 20 and 22 (FIG.1). The walls, legs or portions 20 and 22 are arcuate or curved incross-section. The recessed walls 20 a 1 and 22 a 1 and associatedcut-outs 16 and 18 cooperate to define the rod-receiving channel 26 thatreceives the rod 28 (FIG. 7). The retractor body 12 comprises at leastone or a plurality of lips or flanges 20 b and 22 b integrally formed inwalls 20 and 22 and that engage and cooperate with the lip or flange 30b 1 on receiver 30 to retain the receiver 30 in the area 24 and on theretractor body 12. In the illustration being described the first andsecond elongated portions or legs 20 and 22 are resilient and elastic sothat they can deflect to receive the receiver 30 when it is received inthe area 24 between the inner walls 20 a 1 and 22 a 1. In theillustration being described, a friction or interference fit is providedso that the receiver 30 can be slid onto and rotated within theretractor body 12 in the embodiment shown in FIGS. 1-8.

During a surgical procedure, a surgeon makes an incision and theretraction device or apparatus 10, which has an assembly of the receiver30 and screw 29 a after the screw 29 a is received in the receiver 30and the receiver 30 is received in the receiving area 24, is insertedthrough the incision and the screw 29 a is screwed into bone with ascrew driver (not shown) inserted through the aperture 14 of retractorbody 12. The retractor, retraction device or apparatus 10 causes thetissue to be retracted during the act of the placement of the polyaxialscrew 29.

It should be understood that after the screw 29 a is placed and screwedinto the bone of the patient, a tool 32 (FIG. 7) may be inserted intothe aperture 14 of the retractor body 12 in the illustration of FIGS.1-8. The tool 32 comprises a working end 32 a that is received in thechannel or slot 30 a of the receiver 30. After the rod 28 has beenpositioned in the desired position subsequent to screw 29 a placement,the tool 32 can be received in the channel or slot 30 a and the receiver30 rotated (clockwise in the illustration being described) in order tolock the receiver 30 onto the rod 28. It should be understood that inthe illustration being described the retraction device or apparatus 10does not rotate during the rotation of the receiver 30.

Moreover, as with the second embodiment described later, it should beunderstood that the retraction device or apparatus 10 may be mountedonto the receiver 30 and then the screw 29 a placed or screwed into thebone, thereby providing a single unit for the surgeon to substantiallysimultaneously place the screw 29 a and retract the tissue. It should beunderstood that the screw 29 a and receiver 30 could alternatively beplaced or screwed into the bone and then the retraction device orapparatus 10 placed over and mounted on the receiver 30 if desired.

Note that the retractor body 12 comprises the rod-receiving channel 26that is generally elongated and traverses a majority or substantiallyall of the length of the retractor body 12. The rod-receiving channel 26is aligned with the opening 30 a 1 of the rod-locking channel 30 a sothat when a rod 28 is placed in the rod-receiving channel 26 of theretractor body 12 it can be easily aligned with and guided into theopening 30 a 1 of the rod-locking channel 30 a and downward toward theseat 30 a 2, as illustrated in FIGS. 6 and 7.

After the rod 28 is positioned in the seat 30 a 2, the tool 32 (FIG. 7)can be used to rotate the receiver 30 to lock the rod 28 in the receiver30. After the receiver 30 locks the rod 28 therein, the retractor body12 can be removed and dismounted from the receiver 30 by pulling it awayfrom the receiver 30. In this illustration, the rod-receiving channel 26in the retractor body 12 is substantially linear or straight, while therod-locking channel 30 a in the receiver 30 is not straight and isgenerally L-shaped as shown. FIGS. 7 and 8 illustrate the receiver 30after it has been rotated from the unlocked position (FIG. 7) to thelocked position (FIG. 8) using the tool 32.

In the illustrations described herein, the retractor body 12 is tubularand cylindrical, but it should be understood that it could takedifferent forms, such as a solid form, without departing from the scopeof the invention. For example, the retractor body 12 could benon-cylindrical (e.g., hexagonal, octagonal, square or like).

In the illustration being described, an indicia 39 a (FIG. 8) may beprovided on the retractor body 12 and a second indicia 39 b provided onthe outer surface 30 b to facilitate aligning the rod-receiving channel26 with the opening 30 a 1 of the rod-locking channel 30 a.Alternatively, and as described later herein relative to otherembodiments, a coupler 31 (FIG. 9) may be provided that facilitatescoupling and aligning the retractor body 12 to the receiver 30.

Note that a dimension or width (as viewed in FIG. 4) of therod-receiving channel 26 is substantially the same as a dimension orwidth of the inlet 30 a 1 of the rod-locking channel 30 a.Advantageously, the channel 26 and retractor body 12 provide analignment guide for receiving the rod 28 and directing the rod 28through the slot or channel 26 and into the rod-locking channel 30 a ofthe receiver 30.

FIGS. 9-13 illustrate another embodiment of the invention. Like partsare identified with the same part numbers in this embodiment, exceptthat an apostrophe (“ ”) has been added to the part numbers in thisembodiment.

In this embodiment, the retraction device or apparatus 10 rotates withthe receiver 30 during locking of the rod 28 in the receiver 30. In thisillustration, note that the retractor body 12 of retraction device orapparatus 10 comprises a generally L-shaped rod-receiving channel 34(FIG. 10) that has a shape and dimension that generally complements ashape and dimension of the rod-locking channel 30 a of the receiver 30.As best illustrated in FIGS. 11 and 12, the rod 28 is inserted into anelongated portion 34 a of the rod-receiving channel 34 and then moveddownward (as viewed) into opening 30 a 1 . Notice that after the rod 28is placed in the seat 30 a 2 of rod-locking channel 30 a of the receiver30 both the retraction device or apparatus 10 and the receiver 30, arerotated together to the locked position, as illustrated in FIGS. 11 and12.

After the receiver 30 is locked onto the rod 28, the retraction deviceor apparatus 10 may be rotated relative to the receiver 30 in acounterclockwise direction in the illustration being described and thenremoved or detached from the receiver 30. In this regard, the frictionalfit engagement and clamping force between the recessed wall 20 a 1 and22 a 1 and the outer surface 30 b of the receiver 30 is less than thecoupling strength between the receiver 30 and the rod 28, therebypermitting the retraction device or apparatus 10 to rotate after thereceiver 30 is locked onto the rod 28 and without rotating and unlockingthe receiver 30 from the rod 28.

As illustrated in FIGS. 9-11, the receiver 30 may comprise a coupler 31,such as a notch, tooth or other male projections 20 a 2 and 22 a 2 thatare received in notched-out areas or slots 30 d 1 and 30 d 2,respectfully. This feature facilitates locking the retraction device orapparatus 10 to the receiver 30. This feature also reduces orfacilitates reducing undesired rotation of the retraction device orapparatus 10 relative to the receiver 30 during rotation of theretraction device or apparatus 10 and receiver 30 and locking of thereceiver 30 onto the rod 28. The coupler 31 also facilitates automaticor quick alignment of channel 34 with the rod-locking channel 30 a whenthe retractor body 12 is mounted on the receiver 30.

Referring now to FIGS. 14-21, another embodiment of the invention isshown. In this embodiment, like parts are identified with the same partnumbers, except that a double apostrophe (“ ” ”) mark has been added tothe part numbers in FIGS. 14-21. In this embodiment, an implant systemis shown comprising a polyaxial screw assembly similar to the assemblyshown in FIGS. 6-13. This embodiment further comprises a reducer 60″,which will be described later herein. The retractor body 12″ isdetachably mounted onto the polyaxial screw 29″ and receiver orpolyaxial screw receiver 30″ in the manner describer earlier.

As with the embodiments illustrated in FIGS. 6-13, the retractor body12″ detachably mounts onto the outer wall 30 b of the polyaxial screwreceiver 30″. The retractor body 12″ further comprises a rod-receivingchannel 34″. The rod-receiving channel 34″ becomes generally alignedwith an opening 30 a 1″ and ultimately to the seat 30 a 2″. As with theprior embodiments, the rod-receiving channel 34″ and the retractor body12″ is adapted to facilitate urging and guiding the rod 28″ into thechannel opening 30 a 1″ and ultimately to the seat 30 a 2″ in the mannerdescribed herein.

The retractor body 12″ comprises the first elongated portion, leg orwall 20″ and the second elongated portion, leg or wall 22″ as shown. Anend 20 a″ of the first elongated portion 20″ has the inner or recessedwall 20 a 1″, and end 22 a″ of the second elongated portion 22″comprises the inner or recessed wall 22 a 1″. The recessed walls 20 a 1″and 22 a 1″ cooperate to define the area 24″ for receiving the polyaxialscrew receiver 30″.

As with prior embodiments, the first and second recessed walls 20 a 1″and 22 a 1″ of the first and second elongated portions 20″ and 22″ aredimensioned and adapted to be mounted onto the outer surface 30 b″ ofthe polyaxial screw receiver 30″. A friction, press or interference fitis provided so that rotating the retractor body 12″ will cause thepolyaxial screw receiver 30″ to rotate as in the embodiment illustratedin FIGS. 9-13. This rotation is performed after the rod 28″ has beenreceived in rod-receiving channel 34″, guided into and received in theopening 30 a 1″ and seat 30 a 2″ of the rod-locking channel 30 a″ inorder to cause the rod 28″ to be received in the locking seat 30 a 3″ ofthe polyaxial screw receiver 30″. As mentioned, the first and secondelongated portions or legs 20″ and 22″ are elastic and resilient andpermit the ends 20 a″ and 22 a″ to separate to receive the polyaxialscrew receiver 30″ until it is captured in the receiving area 24″. Aswith the prior embodiment, notice that the polyaxial screw receiver 30″may comprise the edge or lip 30 b 1″. The retractor body 12″ comprisesthe internal lip or flanges 20 b″ and 22 b″ that cooperate with the lip30 b 1″ to retain the retractor body 12″ on the polyaxial screw receiver30″.

The at least one inner wall, such as recessed wall 20 a 1″ and recessedwall 22 a 1″, is adapted to frictionally engage the outer surface 30 b″so that by rotating the retractor body 12″, the receiver 30″ will alsorotate until the rod 28″ becomes locked in the rod-locking channel 30 a″of polyaxial screw receiver 30″. In another illustrative embodiment, theat least one inner wall, such as inner wall 20 a 1″ and inner wall 22 a1″, are mounted on the polyaxial screw receiver 30″ and are adapted topermit the polyaxial screw receiver 30″ to be rotated to lock the rod28″ in the polyaxial screw receiver 30″ while the retractor body 12″ isheld stationary as in the embodiment of FIGS. 1-8. In that application,the retractor body 12″ is held stationary while a tool, such as the tool32″ in FIG. 7, is used to rotate the retractor body 12″ to the lockedposition whereupon the rod 28″ becomes locked in the polyaxial screwreceiver 30″.

As with the embodiment illustrated in FIGS. 9-13, the rod-receivingchannel 34″ comprises a shape, configuration and/or dimension that isgenerally the same as the shape, configuration or dimension of therod-locking channel 30 a″ so that when the retractor body 12″ is mountedon the polyaxial screw receiver 30″, the rod-receiving channel 34″ androd-locking channel 30 a″ become generally aligned. It should beunderstood that, as with the prior embodiments, the receiving area 24″generally defines a female receiving area that generally complements theshape of the outer surface of the polyaxial screw receiver 30″. Thisalignment enables the retractor body 12″ to be rotated in a firstdirection, such as in a clockwise direction, to cause the polyaxialscrew receiver 30″ to rotate and lock the rod 28″ in the polyaxial screwreceiver 30″ after the rod 28″ has been moved through the rod-receivingchannel 34″ and into the rod-locking channel 30 a″. Thereafter, theretractor body 12″ may be rotated in a second direction, which isgenerally opposite the first direction, after the polyaxial screwreceiver 30″ is locked onto the rod 28″ and without rotating thepolyaxial screw receiver 30″ in the second direction as mentionedearlier. In this regard, after the rod 28″ has become locked in thepolyaxial screw receiver 30″, the retractor body 12″ can be rotated soas to align the rod-receiving channel 34″ with the rod 28″ so that theretractor body 12″ can be moved axially (in the direction of arrow A inFIG. 18) away from the polyaxial screw receiver 30″ and dismountedtherefrom.

The retractor body 12″ is fit or mounted onto the polyaxial screwreceiver 30″ with a friction, press or interference fit. As mentionedearlier, the frictional engagement and gripping strength between thefirst and second inner walls 20 a 1″ and 22 a 1″ and the outer surface30 b″ of the polyaxial screw receiver 30″ is less than a frictionalengagement and coupling strength between the polyaxial screw receiver30″ and the rod 28″. This permits the retractor body 12″ to rotate(counterclockwise in the illustration) about the outer wall or surface30 b″ after the polyaxial screw receiver 30″ is locked onto the rod 28″and without unlocking or rotating the polyaxial screw receiver 30″ tothe unlock position.

As illustrated in FIG. 14, the rod-receiving channel 34″ is generallyL-shaped like the embodiment of FIGS. 11-13. A portion 34 a″ (FIG. 14)traverses a substantial or majority of a length of the retractor body12″. It should be understood, however, that the retractor body 12″ ofthe type illustrated in FIGS. 1-20 could also be used with thisembodiment and comprise a channel, like the channel 26″ that issubstantially straight or linear, that traverses a majority of a lengthof the retractor body 12″. Thus, the rod-receiving channel 34″ could beentirely straight or linear even though the rod-locking channel 30 a″ isnot entirely straight. Alternatively, both the rod-locking channel 30 a″and the rod-receiving channel 34″ could be either linear or non-linearas illustrated in the figures.

As with the embodiment shown in FIGS. 11-13, the retraction device orapparatus 10″ may comprise the coupler 31″ for facilitating coupling andsecuring the retractor body 12″ onto the receiver 30″. In theillustration described, the coupler 31″ may comprise the at least one ora plurality of projection 20 a 2″ and 22 a 2″ in the walls 20″ and 22″of the retractor body 12″. As described earlier herein, the projections20 a 2″ and 22 a 2″ mate with and are received in the notched-out areas30 d 1″ and 30 d 2″ in receiver 30″. The notched-out areas 30 d 1″ and30 d 2″ each have a shape that generally complements the shape of theprojections 20 a 2″ and 22 a 2″.

As with the embodiment illustrated in FIG. 10, for example, the coupler31″ facilitates securing the retractor body 12″ to the receiver 30″ andcausing the rod-locking channel 30 a″ and rod-receiving channel 34″ tobecome generally aligned. If a coupler 31″ is not provided, the indiciaor marking 39 a, 39 b (FIG. 8) or other means for aligning therod-receiving channel 34″ with the opening 30 a 1″ of the rod-lockingchannel 30 a″ may be provided.

As with the prior embodiments, the retractor body 12″ is generallytubular and comprises the first wall 20″ and the second wall 22″ thatare defined by the cut-out cut-outs 16″ and 18. The cut-outs 16″ and 18″cooperate to define the rod-receiving channel 34″ as with the priorillustrative embodiment.

As with prior embodiments, the retractor body 12″ is sized and adaptedto permit a tool, such as the tool 32″ (FIG. 7), to be placed in theaperture 14″ in order to either rotatably drive the receiver 30″ or toengage the head (not shown) of the screw 29 a″ in order to screw thescrew 29 a″ into bone during the surgical procedure.

One feature of the embodiment shown in FIGS. 14-21 is the use of areducer 60″ for urging or driving the rod 28″ in the rod-receivingchannel 34″ until it is received in the opening 30 a 1″ and seats 30 a2″, 30 a 3″ of the rod-locking channel 30 a″. The reducer 50″ comprisesa non-linear reducer channel 66″ which in the embodiment illustrated inFIGS. 14-21 is helical. Note in the illustration being described thatreducer 60″ comprises a tubular wall 61″ having a first cut-out 62″ anda second cut-out 64″ which cooperate to define the reducer channel 66″.The rod 28″ may be placed through the cut outs 62″ and 64″ asillustrated in FIG. 14 and into the reducer channel 66″. In theillustration being described, the first and second cut-outs 62″ and 64″define wall portions 61 a″ and 61 b″ that are helical. The cut outs 62″and 64″ and wall portions 61 a″ and 61 b″ and are spaced approximately180° apart to define the helical reducer channel 66″. An end 61 c of thewall 61″ comprises a generally circular knob or grip 68″ forfacilitating gripping the reducer 60″. The grip 68″ is integrally formedwith the tubular wall 61″ and capable of rotating the wall 61″ uponrotation of the grip 68″. The grip 68″ also comprises an annular flange72″ that engages and cooperates with a seat 74″ in the retractor body12″ so that the reducer 60″ may be rotatably mounted onto the retractorbody 12″. As shown in FIG. 21, another embodiment is provided where thetubular wall 61″ is dimensioned and adapted to be received in theaperture 14″ inside the retractor body 12″ as shown.

As best illustrated in FIG. 14, the reducer 60″ comprises an area 80″that is dimensioned and adapted to receive and permit rotation of theretractor body 12″ inside the reducer 60. The rod 28″ is placed andtraversed through the reducer channel 66″ and through the rod-receivingchannel 34″ as shown. The reducer knob, grip or handle 68″ is rotatedwhich causes the rod 28″ to traverse the length of both the reducerchannel 66″ and the rod-receiving channel 34″ in the retractor body 12″,as illustrated in FIGS. 15-17.

The ends of the tubular wall portions 61 a″ and 61 b″ each comprise astop 82″ (FIG. 17) that engages and captures the rod 28″ when the rod28″ has reached the end of its travel in the reducer channel 66″ and isreceived in the seat 30 a 2″ of the rod-locking channel 30 a″, asillustrated in FIGS. 17 and 18. In the illustration, the stop 82″comprises a curved seat 82 a″ formed or provided at the ends of the wallportions 61 a″ and 61 b″. The curved seat 82 a″ captures and engages therod 28″ as shown in FIG. 17.

After the rod 28″ is received in the seat 30 a 2″ of the rod-lockingchannel 30 a″ of the receiver 30″, the reducer 60″ may be removed fromthe retractor body 12″ by moving the reducer 60″ axially in thedirection of arrow B in FIG. 18. After the reducer 60″ has been removedfrom the retractor body 12″, the receiver 30″ may be rotated (in aclockwise direction in the illustration being described) to lock the rod28″ in the receiver 30″ in the manner described earlier relative toFIGS. 9-13. Alternatively, the retractor body 12″ may be rotated byusing the tool 32″ in the manner illustrated in FIG. 7 relative to theprior embodiment.

In order to stabilize or retain the retractor body 12″ in a stationaryposition during rotation of the reducer 60″, a stabilizer 40″ (FIGS. 15and 16) or means for stabilizing the retractor body 12″ may be provided.In the illustration being described, the stabilizer 40″ may take theform of a plurality of apertures 40 a″ and 40 b″ in the retractor body12″ wall. During use, a tool (not shown), such as a screwdriver or otherelongated shafted tool or dow, may be placed through the apertures 40 a″and 40 b″ and used to hold the retractor body 12″ stationary duringrotation of the knob 68″ of reducer 60″. The tool (not shown) may alsobe used to rotate the retractor body 12″ in order to rotate the receiver30″ to an unlocked or locked position and to pull or detach theretractor body 12″ from the receiver 30″.

It should be appreciated that a length of the reducer 58″ is selected sothat when the rod 28″ has reached the stops 82″ at the ends of the wallportions 61 a″ and 60 b″, respectively, the rod 28″ is seated at theseat 30 a 2″. This facilitates properly situating and seating the rod28″ in the rod-locking channel 30 a″ before the receiver 30″ is rotatedfrom the open position shown in FIG. 18 to the locked positionillustrated in FIG. 19.

In the illustration being described, the retraction device or apparatus10 is made of stainless steel, but it should be understood that it couldbe made of any suitable material that is capable of performing thefunctions described herein. Thus, for example, the retraction device orapparatus 10 could be made of a polymer material, plastic, compositematerial, metallic material, such as titanium, or other suitablematerial.

Advantageously, the retractor and reducer systems and methods describedherein provide means, system and apparatus for guiding or placing apolyaxial screw in a patient and/or situating a rod in the polyaxialscrew, while substantially simultaneously retracting tissue during asurgical procedure.

While the form of apparatus herein and methods described constitutes apreferred embodiment of this invention, it is to be understood that theinvention is not limited to this precise form of apparatus, and thatchanges may be made therein without departing from the scope of theinvention.

What is claimed is:
 1. A reducer system comprising: a polyaxial screwreceiver having a rod-locking channel; and an elongated tubular memberhaving a generally helical reducer channel, said elongated tubularmember being adapted and configured to mount onto said polyaxial screwreceiver; said generally helical reducer channel receiving a rod andcausing said rod to move in said generally helical reducer channel alongan axis of said elongated tubular member and toward said rod-lockingchannel of said polyaxial screw receiver in response to a rotation ofsaid elongated tubular member, an inner diameter at an end of saidelongated tubular member being larger than an outer diameter of saidpolyaxial screw receiver so that said end of elongated tubular membercan be situated circumferentially around said polyaxial screw receiver;said rod-locking channel of said polyaxial screw receiver extendingalong a channel length from a top of said polyaxial screw receivertoward a bottom of said polyaxial screw receiver; at least a portion ofsaid elongated tubular member being adapted to extend over and at leastpartially surround said polyaxial screw receiver so that said end ofsaid elongated tubular member extends past said top of said polyaxialscrew receiver towards said bottom of said polyaxial screw receiveralong said channel length so that when said generally helical channelreceives said rod, said rod is urged to move into said rod-lockingchannel in response to rotation of said elongated tubular member.
 2. Thereducer system as recited in claim 1 wherein said generally helicalreducer channel is non-linear.
 3. The reducer system as recited in claim1 wherein said reducer channel is helical, said elongated tubular memberfurther comprising a tubular wall having a first cut out area and asecond cut out area, said first and second cut out areas being spacedapproximately 180 degrees and defining said generally helical reducerchannel.
 4. The reducer system as recited in claim 1 wherein saidelongated tubular member comprises a grip for manually rotating saidelongated tubular member.
 5. The reducer system as recited in claim 1wherein said elongated tubular member comprises at least one stopassociated with said generally helical reducer channel to prevent overrotation of said elongated tubular member once the rod is captured in aseat of said rod-locking channel or said polyaxial screw receiver.